Individual provider Active NPI

Christian Frederick Fetsch, L.AC., M.S.T.C.M.

  • Acupuncturist
  • Minneapolis, MN
National Provider Identifier
1528269743
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1246 Issued in MN
Practice address
100 W 46TH St
Minneapolis, MN 55419-4950
Phone
(612) 871-2288
NPI assigned
May 29, 2007
Last updated
Dec 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1246 MN Primary

Addresses

Primary practice location

100 W 46TH St
Minneapolis, MN 55419-4950

Mailing address

623 Aldine St
Saint Paul, MN 55104-2271
Phone (612) 871-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1528269743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 ALDINE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042271",
            "telephone_number": "612-871-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 46TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554194950",
            "telephone_number": "612-871-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETSCH",
        "first_name": "CHRISTIAN",
        "middle_name": "FREDERICK",
        "credential": "L.AC., M.S.T.C.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.